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Waiting at ’death row’

Patients at DMCH neurosurgery ward kept in wait for weeks to die or get worse

Shamin Ashraf and Shaheen Mollah
Atiqur Rahman waited for days at the Dhaka Medical College Hospital (DMCH) to get a date for a life-saving operation. He finally got an assurance that the surgery would be performed soon after a specialist returns from abroad.
One week later in early Tuesday, the 22-year-old honours student from Barisal BM College died, ending a 40-day wait. He had a malignant tumour in his brain.
Atiqur's is just one example of die sufferings patients are made to go through for weeks due to shortages in staff, equipment and other facilities at the country’s only public hospital that boasts a neurosurgery ward.
Expenses snowball with the long waits: in many cases, costs shoot up way higher than the bills of a similar operation at private hospitals.
'Had I been operated upon in time, I could have left die hospital much earlier, " M Ershad Mia, 25, a former shoemaker for Arif Shoe Factory in Chittagong, told The Daily Star on his bed at the observation room of the neurosurgery ward.
The Kishoreganj youth got admitted to the DMCH on June 13 after several appointments with local quacks did nothing to improve his near-paralysed legs. Doctors diagnosed problems in his spine and gave assurance that he would be OK after an operation.
But the long queue for a date got both the arms of the lone bread earner of a five-member family paralysed by August 7.
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"We've already spent here Tk 28,000," Ershad's wife Sanjita Begum said, adding that they had spent Tk 22,000 before coming to the hospital. She said the family has sold one of their village homes for Tk 13,000 and mortgaged the other one for Tk 50,000 to meet treatment costs.
"Please, do something for us. We cannot bear the expenses anymore, " Ershad implored.
UNDERSTAFFED, ILL-EQUIPPED NEUROSURGERY UNIT
On average, 20 people with neurotrauma, including spinal cord problems and brain tumours, get admitted to the neurosurgery ward every day, with another 10 receiving outdoor treatment in the same period. Thirty percent of the hospitalised need surgery, according to hospital sources.
But the country's largest public hospital that draws patients from across the country has only three permanent doctors, sometimes
aided by deputised doctors and interns, to deal with treatment and surgery at the ward.
"We've one operation theatre with a lone operating table for major operations," one doctor said. The ward shares another OT on the ground floor for minor operations, unaided by required number of anaesthetists and nurses.
The department can manage only one scheduled operation and at best two emergency operations in a day with the existing staff and facilities, the doctor said.
Doctors can sometimes scramble one minor surgery if the scheduled one is completed early.
The neurosurgery department does not have any endoscopes. "We hope to receive a donated machine from a former patient shortly," said the doctor.
SUFFERINGS OF PATIENTS
Patients have to wait no less than a week to get admitted to the neurosurgery ward. And then if a surgery
is needed, they do a month-long scramble to fix a date for it
Senior doctors can attend to patients every 10-12 days while the interns afford to visit them after three-four days.
On average, the neurosurgery ward houses some 150 patients against a capacity of 62. Over 50 of the patients have spinal cord injuries and brain tumours, requiring operations in most cases.
Nasiruddin, a young fisherman from Chandpur with spine problems from a trawler accident seven months back got admission to the observation room on May 3. He has already spent Tk 60,000. He does not know when he will get an operation date.
"If operated on at the right time, a patient with spinal cord problems does not need to spend more than Tk 15,000 including costs for medicines and tests. Costs may go up if any major equipment is needed," a doctor said. He said treatment for brain tumour will not exceed Tk
10,000.
But delays force many patients to opt for private clinics where they pay out between Tk 40,000-80,000 to get the operation done in two weeks.
Several patients waiting for operation said food and conveyance use up most of their money. A few doctors allegedly prescribe too many tests, in some cases same tests again, to be done from diagnostic centres of their choice.
The DMCH authorities have asked the government several times to increase manpower at the ward, without any result
"The accommodation problem * will be solved after the construction of the 600-bed DMCH-2," hospital director Brig Gen Abdus Shahid Khan said.
The construction is supposed to begin in the current fiscal year and would be completed in three years. Patients have to fight for a surgery date until then at least